Michael Rowe

Trying to figure out better ways to help people learn.

In Beta podcast: The challenges of early autonomy for students on clinical placement


In this episode of the In Beta podcast we talk to Dr. Danelle Hess. Dr Hess is a lecturer in the Physiotherapy Department at the University of the Western Cape in Cape Town, South Africa. The conversation focuses on the realities and demands faced by physiotherapy students during their clinical placements in resource-constrained environments within South Africa.

Unlike student experiences in places like the UK, physiotherapy students in South Africa have relatively limited contact time with their clinical supervisors. As a result, they’re expected to independently manage their own caseload with minimal oversight and guidance from supervisors. This level of autonomy comes with a steep challenge as the cases the students manage are often highly complex, including patients with gunshot wounds and polytrauma.

Facing such serious clinical scenarios with little supervision can be overwhelming for students. Dr. Hess expressed concern that this demanding situation may lead students to develop coping mechanisms that focus on survival rather than developing their clinical reasoning abilities. The the psychological toll of these kinds of placements impact the mental health of students, increase the risk of burnout, and in some cases, lead to students withdrawing from physiotherapy profession.

Universities have implemented some student support strategies, such as supplemental learning opportunities, mentoring programs, and counselling services. However, striking the right balance between ensuring patient safety, providing quality care, and allowing students an appropriate exposure to diverse clinical presentations remains an ongoing challenge.

Ultimately, Dr. Hess emphasises the critical importance of helping students build resilience and develop healthy coping mechanisms to manage the emotional and psychological demands of working in highly stressful healthcare environments during their training. This eye-opening conversation shed light on the unique challenges physiotherapy students face in under-resourced settings and the need to prioritise their well-being and clinical preparedness.

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